Silicone patch saphenoplasty to prevent repeat recurrence after surgery to treat recurrent saphenofemoral incompetence: long-term follow-up study

Abstract

The use of a silicone patch at repeat operation to treat recurrent varicose veins caused by new incompetence at the level of the saphenofemoral junction is associated with a lower incidence of recurrent thigh varicosities and neovascularization compared with a control group in which no additional barrier technique was used.

Clinical and technical outcomes from a randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins

“…Neovascularization has been implicated as the leading cause of recurrence in several studies 11,28 -31 , with rates as high as 52 per cent at 2 years 11,32 and 79 per cent at 5 years 8,13 ; evidence of neovascularization on duplex imaging at 1 year has shown a positive predictive value for clinical recurrence of 70-100 per cent 33 . This is ultimately linked to the need for reintervention 14 .…”

Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins

“…Various authors have reported the efficacy of silicone patch interposition at SFJt in reducing neovascularization, but there is high incidence of deep vein thrombosis with the use of silicone implant [14,18]. Rij et al reported a highly significant decrease in n e o v a s c u l a r r e c u r r e n c e a t t h e S F J w h e n a polytetrafluoroethylene patch (PTFE patch, 3×3 cm) is interposed between the ligated vein stump and the overlying soft tissue.…”

Retrospective evaluation of the need of a redo surgery at the groin for the surgical treatment of varicose vein

“…[25][26][27][28][29] The frequency of inguinal reflux associated with varicose recurrence in our study conforms to reported figures, 2-4,7-11 with a large amount of neovascularization. Recent publications have reported inguinal neovascularization as the main cause of varicose recurrence [40][41][42] whereas the main cause in older publications was an inadequate initial operation with failure to perform a flush saphenofemoral ligation with ligation and division of all tributaries (so-called extensive crossectomy), leaving a residual refluxing stump. [1][2][3]15,19 Performance of extensive crossectomy by most surgeons for almost 30 years has not reduced the frequency of procedures for varicose recurrence, which remains about 20%, [8][9][10][11]16 but has led to the appearance of a new "source" of varicose recurrence, replacing the residual stump with neovascularization.…”